Letters Response

Andrew Moore and colleagues reply to Des Spence

BMJ 2014; 348 doi: https://doi.org/10.1136/bmj.g1490 (Published 19 February 2014) Cite this as: BMJ 2014;348:g1490
  1. Andrew Moore, honorary senior research fellow1,
  2. Phil Wiffen, honorary professor1,
  3. Christopher Eccleston, professor2,
  4. Michael Lunn, consultant neurologist3,
  5. Richard Hughes, honorary professor3,
  6. Amanda Williams, clinical reader4,
  7. Dominic Aldington, consultant anaesthetist, consultant in pain management5,
  8. Eija Kalso, professor6
  1. 1Pain Research and Nuffield Division of Anaesthetics, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 7LE, UK
  2. 2Centre for Pain Research, University of Bath, Bath, UK
  3. 3National Hospital for Neurology and Neurosurgery and MRC Centre for Neuromuscular Diseases, London, UK
  4. 4Research Department of Clinical, Educational, and Health Psychology, University College London, London, UK
  5. 5Royal Hampshire County Hospital, Winchester, UK
  6. 6Institute of Clinical Medicine, Faculty of Medicine, University of Helsinki and Pain Clinic, Department of Anaesthesia and Intensive Care Medicine, Helsinki University Central Hospital, Helsinki, Finland
  1. andrew.moore{at}ndcn.ox.ac.uk

Spence’s polemic on duloxetine loses power because most of what it is based on is wrong.1 Making pronouncements in respected journals about good and bad medicine comes with the responsibility of knowing what you are talking about. Bad scholarship helps no one, especially those in pain; research in genetics, neurobiology, and psychology has contributed to huge advances in knowledge about the bio-psycho-social origins of pain.

Chronic pain is defined as pain of moderate or severe intensity that lasts for three months or more (think of a really bad headache lasting from Christmas to Easter). It affects one in five adults. Painful conditions are among the most prevalent conditions and are five of the top 11 in terms of years living with disability. Chronic pain destroys …

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